Early Detection of Cancer
The main reason for the high mortality caused by cancer is too late detection of the disease. Higher cure rates are achieved if the disease was detected in the beginnings of an early stage. To increase the chance of surviving cancer, it is therefore important to detect the very first signs of a neoplasia.
Usually, cancer screening and foresight is done by imaging techniques. Standard imaging techniques may have the drawbacks of low sensitivity or to be uncomfortable (e.g. colonscopy). As a consequence, foresight by imaging techniques may be consulted too infrequently or the disease is perhaps detected in a progressed stage. To reduce overall cancer morality, diagnostic methods are required which are sensitive and well tolerated. Acceptance for foresight examinations may be raised if the test is non-invasive, i.e. it can be performed with body fluids like blood, urine, or stool which are easily accessible.
Molecular techniques allow the detection of genetic alterations typically observed in tumors. Cancer is a multi-factorial genetic disease, i.e., multiple genetic alterations have to occur in combination so that a malignant cancer cell can emerge. The very first genetic alterations during the evolution of a cancer cell can be detected in pre-cancerous lesions as well as in the tumors which arose thereof. The presence of such early signs in a patient must not inevitably lead to cancer, but can be considered as a risk factor. As a consequence of the detection of risk factors, changes in nutritional and environmental behavior may be applicable as well as enhanced vigilance to monitor for further progression. We provide several assays for the detection of cancer risk factors from different body fluids:
From blood
This diagnostic test is done on an individual because of clinical suspicion of disease. Because tumor cells can be disseminated to the blood stream early, a cancer screening test can be done with peripheral blood. Improvements in technology made it possible to detect even a few tumor cells. Moreover, detection of disseminated cells can be used to monitor the efficiency of treatment. If the therapy is effective, minimal residual cancer cells should disappear from the bloodstream. A limitation of this assay is that it cannot be specified from which body site these tumor cells are scattered into the blood stream. Furthermore, the neoplasia must also have already progressed and gained access to the circulation. To overcome this limitations, we established detection assays using organ-confined specimens (urine, sputum) allowing a closer localisation of the source of the neoplastic cells.
*supporting evidence from the academic literature:
Fehm T., et al. Cytogenetic evidence that circulating epithelial cells in patients with carcinoma are malignant. Clinical Cancer Research 2002 Vol. 8. 2073-2004.
Comment: Numerous studies of circulating epithelial cells have been described in cancer patients. The vast majority of these circulating epithelial cells in breast, kidney, prostate, and colon cancer patients are aneusomic and are derived from the primary tumor.
From urine
Pre-malignant and malignant cells of prostate cancer or bladder cancer are shed in the urine. We have established molecular tests for the detection of genetic alterations typically seen in such tumors. Urinary detection of these alterations can be indicative for these cancers or pre-malignancies.
*supporting evidence from the academic literature: Hoque MO, et al.:
Quantitative methylation-specific polymerase chain reaction gene patterns in urine sediment distinguish prostate cancer patients from control subjects. J Clin Oncol. 2005 Sep 20;23(27):6569-75.
From sputum
Smokers are at higher risk for developing lung cancer. However, only about 20 % of smokers are affected. It is therefore important to identify those individuals which already progressed to a higher risk state. Pre-malignant and malignant cells of lung-cancer can be detected in sputum. We have established molecular tests for the detection of genetic alterations typically seen in such tumors. Detection of these alterations can be indicative for such cancers or pre-malignancies.
